Elbow
What are the 3 main articulations for mobility of the elbow joint? How does the elbow joint capsule play a role in stability?
Humeroulnar: between trochlea (humerus) and trochlear notch (ulna)
Humeroradial: between capitulum (humerus) and radial head
Proximal radioulnar joint: between radius and ulna
The joint capsule surrounds all 3 joints
If there is no angulation between the long ais of the humerus and the long axis of the forearm what condition exists?
cubitus varus
What are the osteo and arthro kinematic movements at the elbow joint?
between the humerus and the ulna: osetokinematic
between the radius and the ulna: arthrokinematic
Diaphragm, intercostals, scalenes
What type of joint is the costotransverse joint? What are the motions of this joint?
Synovial joint between the rib and facet on transverse process of the corresponding vertebrae
T11-12 DO NOT have these facets allowing articulation
T1-6: rotation
T7-10: main motion is gliding
Which joint in the elbow allows the forearm to perform supination and pronation?
Proximal radioulnar joint- the radius moves over the ulna for pronation and supination
What can happen if you pick kids up by their arms and swing them?
A distraction pull can dislocate the radial head
Why is it important to have a "functional elbow joint"
elbow movement is required for activities like eating, reaching, or pushing up out of a chair
How are spinal curves in scoliosis defined?
based on direction of convexity and region of spine
Ex: right thoracic scoliosis
What type of joint is the costochondral joint? Where is it located?
Synchondrosis joint
Formed by articulation of the ribs 1-10 anterolaterally
What is causes the carrying angle at the elbow and what is the normal carrying angle?
The carrying angle is due to the medial aspect of the trochlea of the humerus extending further distally than the capitulum
Normal angle is 10-15 degrees
How would you optimize the biomechanical effects of both the brachialis and the biceps brachii?
Have the elbow 100 degrees flexed for the biceps to be most effective and the brachialis can flex the elbow too
What is the kinematic motion of the upper and lower ribs during ventilation?
Upper ribs: move like a "pump handle", the upper ribs move superiorly and anteriorly during inspiration
Lower ribs: moves like a "bucket handle", the lower ribs move superiorly and laterally during inspiration
RIB MOBILITY
during rotation the ipsilateral rib becomes more convex as anterior portion of rib flattens
Where is the costo sternal joint located?
articulation between rib and sternum
What are the medial (ulnar) collateral ligaments? What stress do they resist?
Anterior bundle, transverse bundle, posterior bundle
These limit VALGUS stress, when the elbow is put into valgus stress the medial collateral ligaments are put on tension
What primary elbow joint muscle is not affected by either shoulder or radioulnar position?
Brachialis: it attaches to the humerus and the ulna, it is unaffected by the changes in position of the forearm and shoulder- when the forearm moves, only the radius moves over the ulna when supinating and pronating
What are the joints in the thoracic spine and how do they function?
Facet joints: they are positioned more upright/vertical than the cervical region
Function: more in lateral flexion and rotation than flexion/extension
What happens in passive exhilation?
It is passive, the diaphragm returns to its dome shape (moves up)
What are the lateral collateral ligaments? What motion do they resist?
Lateral radial collateral, lateral ulnar collateral and annular ligament
Resists VARUS stress, when the elbow is put in a varus position the lateral ligaments are put in tension
What are considered dynamic stabilizers of the distal radio-ulnar joint?
pronator quadratus and extensor carpi ulnaris
What vertebral bodies would the T4 rib articulate with?
the superior facet on T4 rib would articulate with T3 vertebral body
the inferior facet of the T4 rib articulates with the superior facet of T4 vertebrae
What is happening with diaphragm and rib cage during inhalation?
Diaphragm: contracts (moves down)
Rib cage: moves up